SGLT2 inhibitors reduce incident obstructive airway disease in type 2 diabetes patients

The findings of a retrospective cohort study published in the Journal of American Medical Association suggests that type 2 diabetes patients in Hong Kong who used sodium-glucose cotransporter 2 inhibitors (SGLT2Is) had a lower chance of developing incident obstructive airway disease (OAD) and a lower incidence of exacerbations in a clinical environment than those who used dipeptidyl peptidase-4 inhibitor (DPP4I).

Obstructive airway disease is more common in patients with diabetes. The use of sodium-glucose cotransporter 2 inhibitors has been recommended in recent meta-analyses of post hoc studies of cardiorenal trials to lower the incidence of OAD adverse events. A clinical research into this relationship is necessary, nevertheless. The purpose of this study, which was carried out by Philip C. M. Au and colleagues were to compare the relationship between the usage of SGLT2I and the incidence of OAD and exacerbation episodes in type 2 diabetes patients.

Electronic health information from a Hong Kong territory-wide electronic medical database was used in this retrospective population-based cohort research. Patients with type 2 diabetes who received DPP4Isor SGLT2Is between January 1, 2015, and December 31, 2018, were the subjects of the data collection. A median of 2.2 years of patient monitoring took place between January 1, 2015, and December 31, 2020. In order to match patients based on prior experience to the study medicines, a common new-user design was used. The baseline attributes were balanced using propensity score matching. The initial OAD occurrence and the number of OAD exacerbations were the key results. An analysis of Cox proportional hazards regression model was used to assess the risk of incident OAD.

The key findings of this study were:

30,385 patients were included in this investigation.

The matched OAD cohort (exacerbations analysis) included 381 SGLT2I users and 1524 DPP4I users, whereas the propensity score-matched non-OAD cohort (incidence analysis) included 5696 SGLT2I users and 22 784 DPP4I users.

At baseline, 51% of patients in the OAD group were men, with a mean age of 62.2 (10.8) years and a mean (SD) age of 61.2 (9.9) years for the non-OAD cohort. Usage of SGLT2I was linked to a decreased incidence of incident OAD and a lower frequency of exacerbations when compared to use of DPP4I.

The relationships held up after sex subgroup analysis.

In conclusion, compared to DPP4I usage, SGLT2I use was linked with a decreased rate of OAD exacerbations in clinical settings among individuals with type 2 diabetes in Hong Kong. Both men and women experienced the same outcomes.

Reference: 

Au, P. C. M., Tan, K. C. B., Lam, D. C. L., Cheung, B. M. Y., Wong, I. C. K., Kwok, W. C., Sing, C.-W., & Cheung, C.-L. (2023). Association of Sodium-Glucose Cotransporter 2 Inhibitor vs Dipeptidyl Peptidase-4 Inhibitor Use With Risk of Incident Obstructive Airway Disease and Exacerbation Events Among Patients With Type 2 Diabetes in Hong Kong. In JAMA Network Open (Vol. 6, Issue 1, p. e2251177). American Medical Association (AMA). https://doi.org/10.1001/jamanetworkopen.2022.51177